My Progression Through the Stages of COPD

Editor's Note: This article was originally written by patient expert Bill Hamilton.

Since I have started my blog many folks have asked me how I have progressed through the Stages of COPD. I have been asked: Do you know what caused it? How long have I had COPD? When did it start and how fast has it moved taking over my lungs?   For those questions, I don't have definitive answers.   One of the easiest answers I do have is my COPD didn't start the day I was diagnosed.

My COPD started a long time ago.   It may or may not have started with the first cigarette I smoked or maybe the first time I got bronchitis.   My doctor tells me I was predisposed to COPD, like others are predisposed to heart disease, cancer, or kidney disease.   Even if I had done everything right, lived in a bubble, exercised, ate correctly, and got plenty of rest, I could've or would've ended up with the COPD regardless.

The Stages of COPD

There are four stages of COPD: Mild, Moderate, Severe and Very Severe (which is now starting to be referred to as "End Stage" by some). I like the term End Stage better than Very Severe, or maybe End Stage should be the fifth stage of COPD.

This post is about how I have progressed through those four stages of COPD. I passed through the first two stages of COPD (Mild and Moderate) without really having a clue, but it took 20 years to get through those two stages.   Along the way I believe I had plenty of signs:   repeated bouts of bronchitis (one or two times a year for years), shortness of breath (SOB), mucus production, as well as some wheezing and chest tightness. These were indications of respiratory problems that, for the most part, went untreated. Being a heavy smoker and overweight were excuses on which I blamed my SOB and tendency for being ill.

You need to realize you can have all of these symptoms and still not have COPD. But they are indications that you should have a serious conversation with your doctor regarding your potential for respiratory issues.

Getting Diagnosed

I was officially diagnosed with COPD in 2004 (after an extensive series of breathing tests). At the time of my diagnosis I was already at the end of the Moderate stage and beginning the Severe stage of COPD.   Remember it took 20 years to get to this point. It was at this point that I really began to use prescribed medications and pay close attention to the doctor's instructions.   A sleep study showed I needed a CPAP machine for breathing at night. But other than a rescue inhaler and Spiriva, no significant changes to my lifestyle or other normal habits were required or requested.   Though it was suggested that I lose some weight.


Another significant medical event occurred in 2006, which I am sure played a role in my future.   I had a Bi-lateral Pulmonary Embolism.

Then came 2008; it wasn't a good year. In March it was discovered that I needed heart bypass surgery.   Three days after successful heart surgery a hole developed in my left lung. Tendays of waiting for the hole to heal itself was not fruitful, and on the eleventh day I was again in surgery to fix the hole. There were some complications, which resulted in me being in the hospital for a total of 102 days.   These complications moved me quickly through the Severe stage right into Stage 4 (Very Severe).

Folks, the complications I had were by no means normal.   And while the heart surgery was quite serious, it didn't hasten my progression through Stage 3 into Very Severe COPD (stage 4).   But I truly believe without these other medical issues between 2004 and 2008 that I would most likely still be in the Severe stage. Still enjoying both golf and bowling.   I did make lifestyle changes, including a better diet, more exercise, and not putting myself in places where I knew my lungs would be irritated to adjust to life with COPD.   These are changes I advocate to anyone having COPD.

Between March of 2008 and February 2014, I had been admitted to the hospital more than10 times for COPD-related illnesses.   Each trip to the hospital has been like taking a step down the ladder.   I would go into the hospital at one level and come out at a lower level of function, never gaining back the functionality I had lost.

Take Care,


*Editor's Note: On September 3, 2014 Bill Hamilton lost his battle with COPD after years of fighting and helping the COPD community.